Lumpectomy or mastectomy? How did you decide?

does that study say only mastectomy or were chemo and rads included with mmastectomy?

PRB, take one day at a time, if you don't need chemo, that is awesome....but two things: 56 is YOUNG, and chemo (although not fun) is very doable. I worked full time, traveled some, kept involved with my DS's activities etc. etc. throughout treatment. Nobody knew I was sick unless I told them. If you take a no nonsense, "this is something crappy that happened to me, I will get through it and move on' approach, then that is how people around you will handle it too.

The not knowing is the worst part; once you have a treatment plan in place, then you just do it and get it over with. Everything about it is hard; but you can get through it and come out on the other side being really, truly O.K.

"Five Lessons I didn't learn from breast cancer (and One Big One I Did) by Shelley Lewis.....I read this book twice and my husband also read it....I did create a CANCER FREE ZONE and all of that was helpful to my Spirit....to this day I stay away from Toxic people and since it has been almost three years, it feels like it did not happen at this point....I did approach people to walk with me and they were all in the medical field and that was a GREAT help.....I had people who knew what was going on.....right from the get go I did not want to do Chemo or Rads......and I did not......but my oncologist said I did not need to do that, the Mastectomy was my cure....he only suggested I talk with my gyno and he in turn consulted with a gyno onc......they knew it would travel to the uterus so I did do a hysterectomy......and Here I am OK!! You will do well once you make your own decision....Liz

When I found out I had breast cancer the first time, they said I only needed a lumpectomy and chemo/radiation treatments. I didn't know much and followed what I was told. I met my radiation doctor shortly after I found out. I didn't get to meet my chemo doctor until two months later. I always wished I met him sooner, to answer questions and fears I had. When I had reconstruction surgery and they found more cancer during that surgery. I was told about it the next morning that they got it all and again need to do chemo/radiation. Now, looking back after getting breast cancer in my left breast in 2012 and what my new breast doctor has told me. I wish I did the double mastectomy at least by the second find. By then, my twin and I both went thru it twice, our BRACA test was negative. This information should have prompted the suggestion to remove my left breast. Unfortunately we follow what the doctors tell us and pray for the best. I never imagined even getting breast cancer a second or third time. I am so thankful to be alive and I thank God for seeing me thru. My twin died from the breast cancer spreading. My older sister opted to have a double mastectomy as a precaution. They found out she had breast cancer a month before she was due to have surgery. My older sister said her doctor said she was at a higher risk of getting breast cancer because of the BRACA test I took came back negative. Find out as much information you can, follow your heart and don't let the doctors tell you are crazy. This third time I already said remove breast no matter what results are because I didn't want to take chances. I hope to be of help for you or anyone else.

Liz, that's just really strange. I've been reading everything I can find about breast cancer and particularly DCIS for 8 years now, and I'm a research junkie, and everything I've read says that BC mets to the uterus is very rare. The risk of uterine cancer related to breast cancer relates specifically to Tamoxifen.

When I have more time I will dig into this more, but if anyone has heard anything different in this regard or has any studies that suggest that this is a risk, I would be very interested to see it.

The other thing I don't understand is that while the MRI might show something suspicious or concerning, ultimately it's the pathology of the cancer - what's seen under the microscope - that determines the diagnosis and prognosis. So while it may have appeared on the MRI that your DCIS was in the process of converting to become IDC, if the pathology showed all DCIS with no microinvasions or larger areas of IDC, then the diagnosis was pure DCIS, Stage 0, and that means that the cancer cannot move beyond the breast, regardless of what the MRI might have shown. So spread to the uterus (or anywhere in the body beyond the breast) with pure DCIS just doesn't happen, at least not unless you have an invasive recurrence first. What you were told just seems to be completely contrary to my understanding. Very odd.

Liz, sorry, I didn't mean to appear to be challenging you. I understand that you are happy with your choices and it's great that you are doing well. I was asking the questions because I'm confused by what you were told and I thought that there might be more to it. I also was keeping in mind that PRB1956 is struggling with her decision about a lumpectomy vs. mastectomy and I wanted to ensure that she understood that the need for chemo is not affected by her surgical choice. I also didn't want her to be worried about a risk of uterine cancer, or to be thinking that she may need more surgeries ahead, such as uterine removal. While that may have been recommended to you, from my almost 8 years on this board, I think I can safely say that's not part of the treatment plan for most women.

I LOVE what Ruthbru posted from Beesie.

Everyone should get a copy who has to make this decision.

I would add a comment, my 2 cents, where it discusses rads being "less time" (dont quote me)recuperating as opposed to mastectomy...the length of time to go throu treatment for rads , for me (6weeks) will be as long or longer than my recovery from mastectomy. With that said, we all heal differently...I am 1 1/2 weeks out from double mastectomy and am feeling great...I did not have SNB or axilliary nodes this go around though, which does cause more pain.

Also, another method I use when making these big decisions, and I use it in other areas if my life...is the "pros vs. Cons". So make 2 columns for pros vs. cons for lumpectomy and then the same for mastectomy...then weigh the importance of those pros and cons..sometimes the answer is staring you in the face. It helps to get it on paper and out from "swirling in your head".

Pat

I had DCIS, stage 2 in one breast and LCIS in the other. I had a BMX with immediate reconstruction 8 wks ago. According to my oncologist, DCIS only occurs in ducts. If you have a mastectomy, you cannot develop DCIS in that breast again. If you have a lumpectomy, you can develop DCIS again in that breast. Yes, after mastectomy there is always a small % of breast tissue left, BUT no more ducts so DCIS cannot reoccur. DCIS is not associated with any other kinds of cancer occurring somewhere else.

LCIS only occurs in lobules. Most of the same info applies. If you have no more lobules, you cannot get LCIS again in that breast. But LCIS is more worrisome because it is associated with a greater chance of developing a different kind of cancer somewhere else, including the other breast. My oncologist said I absolutely made the right decision by having a BMX instead of lumpectomies and she would have done the same in my shoes.

If you have invasive cancer, it's a different story. Neither DCIS nor LCIS are invasive. If you have a positive lymph node, it's a different story. Many surgeons do not check even one lymph node if you have DCIS. Mine did a sentinel node biopsy: 1 negative node on DCIS side, 3 negative nodes on LCIS side. My oncologist said there is no need for radiation, chemo, or hormone therapy.

Beesie, my oncologist says you are wrong. I asked today after I read your comment. Although it is possible to develop another kind of cancer in the tiny bit of breast tissue that remains after the BMX, she says there is most certainly no duct or lobule tissue left. DCIS can only start in ducts and LCIS can only start in lobules so there is 0% chance of be developing those two kinds of cancer ever. My sentinel node biopsy was 0/4. Doesn't mean I couldn't get some other kind but it won't be DCIS or LCIS.

My breast surgeon has seen imaging that revealed microscopic milk ducts that had grown into the skin layer. He said it made him rethink how DCIS can remain behind after mastectomy. It only takes one DCIS cell left behind which is the basis for the non-zero risk of recurrence after MX for DCIS.